Ask a Doc Gad Zooks Now We Have to Worry About Zika

February 2, 2016

Dear Doc:

What is the Zinka Virus, the news about it is everywhere! Is it likely to affect my family in Upstate New York?

Dear Reader:

Imagine a nation issuing an advisory that women avoid pregnancy. That announcement, addressed to young women in El Salvador, Columbia, Ecuador and Jamaica was issued just last week. President Obama held a high level conference, the State department is calling home all pregnant staff members and the airlines are refunding tickets issued to pregnant women planning trips to South America. Obviously a country recommending against procreation is a drastic measure. What could possibly be of such danger to prompt this recommendation? And, is it likely to affect my family here in Upstate New York?

To understand this concern we first must discuss a pediatric condition known as microcephaly or infants with an undersized brain. In the unborn fetus the head grows in response to the growth of the brain. Abnormally small brain growth leads to microcephaly (small head). The condition is quite rare; about 1- 2 cases for every 10,000 live births. It can occur from a genetic abnormality or exposure before birth to chronic alcohol ingestion or to infections such as Rubella, Toxoplasmosis and Cytomegalovirus. These infants usually have developmental delays, seizures, difficulty swallowing, visual impairment and deafness.

All infants have their head size measured on the first day of life and at each checkup during the first year of life. Abnormalities in the size of the head are investigated with brain imaging studies such as a head CT scan or MRI. Microcephaly is a lifelong, permanent and usually disabling condition.

Since just this past October, a sharp increase has been observed in Brazil of the number of infants born with microcephaly. The increase was astounding, at a rate nearly 400 times higher than expected. Imagine 4,180 new cases of microcephaly in 3 months compared to the usual Brazil incidence of 150 cases in all of 2014. This sudden increase of microcephaly has occurred at the same time as a dramatic increase has been observed in Zika Virus infections which are transmitted by an aggressive daytime biting mosquito of the Aedes species.

More bad news is that many of these microcephaly infants and their mothers are testing positive for Zika Virus infection during gestation and that the expected case infection rate is modeled to explode in areas where these Aedes mosquitoes reside. The good news (for us in Wayne County) is that Zika bearing mosquitoes do not live here in Western New York as we are currently north of the Aedes range.

But beware, southern Pennsylvania and downstate New York may have an issue later this summer since some Aedes do extend that far.

There is neither vaccine nor medication to treat Zika Virus infections. For now, if pregnant do not travel to Central or South America, the infection is even turning up on the islands of the Caribbean. If in the areas affected take all the same precautions you would if you were headed for the Adirondack Park in May; DEET insect repellant and long sleeve shirts and pants, even head nets and don’t open the screens. A unique approach to reduce the risk has been tried in Key West, Florida by introducing a genetically modified Aedes male whose gene is lethal to its offspring. The effectiveness and environmental implications of that approach are yet to be answered but it’s promising. Until then, pass the repellant.

Michael Jordan, MD, MS-HQSM, CPE, FAAP, Chief of Pediatrics at Newark-Wayne Community Hospital is board-certified in Pediatric Medicine. He attended the College of Human Medicine at Michigan State University and completed his residency training at the University of Rochester. In addition to his leadership role as chief of Pediatrics at Newark-Wayne, he is the medical director of Rochester Regional Medical Group and is also chair of Rochester General Medical Group’s Quality Committee. He works in the Sodus Rochester General Medical Group Pediatric office. To send questions on children’s health, please email Wendy Fisher, Pediatric Practice Manager at [email protected] and write “Ask a Doc” in the subject line. To schedule an appointment, call (315) 483-3214.

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